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Malignant pleural mesothelioma presenting as an acute surgical abdomen due to metastatic jejunal perforation.

Kyoko Gocho, Kazutoshi Isobe, Kyohei Kaburaki, Yoshiko Honda, Aki Mitsuda, Yoshikiyo Akasaka, Nagato Shimada, Keigo Takagi, and Sakae Homma

Intern Med 49(6):597-601 (2010) PMID 20228599

A 52-year-old man was admitted to our hospital in June 2008 presenting abnormal tumor lesions along the left pleura on chest X-ray. The needle-biopsied specimen of the left pleura proved the biphasic type of malignant mesothelioma. However, he complained of acute abdominal pain 7 days after the diagnosis. Chest X-ray revealed free air below the right diaphragm. Emergency surgery revealed a 4-cm perforating jejunal tumor with peritonitis. Histopathology of the resected jejunum demonstrated a metastatic tumor of malignant pleural mesothelioma. This is the first reported case of malignant pleural mesothelioma presenting as an acute surgical abdomen due to jejunal metastasis with perforation.

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